Abstract:

Objective

To explore the surgical technique on advanced pancreatic head cancer in order to improve the resection ratio and review the role of conservative resection for prognosis and survival time of the patients.

Methods

107 patients with pancreatic cancer in the last years were reviewed. CT scans of the pancreas were used to evaluate the stage of the pancreatic cancer especially the invasion of SMA and SMV before surgical intervention.Direct dissection of the pancreatic neck were performed during operation for vessel invasion patients in order to increase the resection ratio. Local chemotherapy and radiotherapy were routinely carried out to lower the recurrence of the tumor.The prognoses of the patients who underwent conservative resection were followed up.

Results

The overall accurate ratio of pancreatic CT scans for vessel invasion was 78.5%, retrospectively. The resection ratio of all patients was 63.55%.Complications occurred perioperatively was 17.5% and one patient died from severe lung infection accompanied with multiple organ function failure.The survival ratios of the remain patients over 6 months,1 and 2 yean were 100%,79.4%and 41.2%respectively.But the ratios of the patients with bypass operations in the same period of time were 76.9%, 51.3% and 15.4% respectively. The significant difference was found in two group though the severity might be different (P＜0.01).

Conclusion

Pancreatic CT scan is one of accurate method in the evaluation of the vessel invasion in pancreatic cancer.Direct dissection of the pancreatic neck is a effective way to increase resectablility of pancreas cancer. Conservative resection of the pancreatic cancer plus local chemo-and radiotherapy can prolong the survival time of the patients with advanced pancreas cancer and further investigation should be followed up.

Key words: Advanced pancreatic cancer, Conservative resection